After working for several years to attain the designation, Cook Children's Medical Center is now officially a Level II trauma facility, meaning it has been recognized for its ability to respond to almost any childhood emergency.

The hospital received the designation from the Department of State Health Services, becoming one of only nine such hospitals in the state.

"This means we can provide services to almost any patient that needs emergency care with the exception of major burns and limb amputations," said Sally Snow, trauma program director for Cook Children's. "For the most part that's the only two things we don't do."

Texas Health Harris Methodist Hospital Fort Worth is the only other Level II facility in Tarrant County. John Peter Smith Hospital has earned the Level I designation, which is the highest rating. Children's Medical Center in Dallas has been a Level 1 trauma center since 2005.

Cook Children's has been providing this level of emergency care for some time. To earn the designation a hospital must function as a trauma center for several years and have a 12-month track record, she said.

For parents, the designation means that if a child under the age of 15 is injured, a 13-member trauma team is available. One requirement is in-house physician coverage 24 hours a day, seven days a week. A doctor has to be at the patient's bedside within 15 minutes of arrival.

With traumatic injuries the major cause of death for those under 45, such facilities play a major role in the community, said Christine DeLoma, a spokesman for the Department of State Health Services.

"Having a trauma facility helps reduce EMS response time, prevent trauma-related deaths and injuries, and increases access to life-saving care for the most critically injured patients," she said.

The trauma team at Cook Children's sees patients with everything from snake bites to gunshot wounds.

In 2009, the hospital admitted 1,090 trauma patients. Of those, 109, or 10 percent, were children injured in motor vehicle accidents. The highest volume, 41 percent, came from falls from everything from skateboards to monkey bars, Snow said.

To become a trauma facility, a hospital must be designated by the state and verified by the American College of Surgeons. Cook Children's did not seek Level I designation because it does not meet the requirement to serve as a teaching hospital and conduct research.

As far back as the 1980s, the hospital wanted to pursue the Level II designation. But it was not until recent years that it had the staff in place to focus on the detailed requirements.

"It's a whole lot of work because you have to put everything in the system under a microscope," Snow said. "We look at every admission from EMS care to follow-up to make sure if there's anything we could do to make the care better."